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Why Preventing Cancer Is Not the Priority in Drug Development

nytimes.com

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Re: Why Preventing Cancer Is Not the Priority in Drug Development

#31
post #9

This isn't a great representation of the issue. Everyone loves to hate the drug companies. First of all, the basic science is lacking. The vast majority of animal models in no way resemble the normal process by which humans develop cancer. The models are designed to grow aggressive cancers extremely fast so you can test drugs rapidly, publish your paper and get the next grant. Even more than that, what actually takes…

I was with you up until this, "A holistic approach to improving our health and well being would be preferable, at least incorporating nutrition, exercise and psychology." I'm all for being healthy, getting good sleep,and exercise, but I dont want to go back to blaming cancer on personality types, or a lack of certain vitamins. Those holistic cancer commercials on t.v. are irritating. Once you have cancer, all that ho…

Actually Jobs prognosis had he not gone with alternative medicine was pretty good.

From a forbes article on the subject

"Jobs’ cancer had been discovered by chance during a CT scan in 2003 to look for kidney stones, during which doctors saw a “shadow” on his pancreas. Isaacson told CBS’ 60 Minutes last night that while the news was not good, the upside was that the form of pancreatic cancer from which Jobs suffered (a neuroendocrine islet tumor) was one of the 5% or so that are slow growing and most likely to be cured."

http://www.forbes.com/sites/alicegwalton/2011/10/24/steve-jo...

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#32
post #28

If there is in fact such a problem with incentives, what entity do you think might have the power to create proper incentives, and what are the odds of it happening? Or perhaps let's shelf this discussion at least until we figure out how to incentivize sustainable development of new antibiotics. In fact, one extremely effective way to reduce cancer-related mortality would be to keep ignoring the problem with antibiot…

I think that's a question we would benefit greatly from answering, if we could.could markets are a powerful and useful thing. But, the longer we play this game the more gaps emerge where human and economic incentives do not meet eye to eye. If it were just a question of funding it would be solvable.

Sorry, I was kidding about "what entity". The same entity that traditionally steps in to solve the needs that otherwise are not met due to tragedy of the commons -- government.

Patents, copyright protections (yes, they're screwed up now, but better than without), infrastructure like roads or postal mail historically.

Just that US legislative process is spinning its wheels at the moment and for the foreseeable future.

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#33
Well, preventing Cancer has been a priority for evolution since the first multicellular organisms arose. It's just not that easy.

Developing a drug is an economically difficult thing: Spend billions for the chance to win billions. The only alternatives to big pharma in developing these drugs are big government and big charity (Gates' Foundation et al).

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#34
Just remember, Cancer isn't a disease.

It is hundreds of different disease related to mutations in the function of cell division. Cells that don't need to divide, start dividing but the daughter cells are not the same as the parent.

In order to treat Cancer with a drug, you need to identify which of the hundreds of subtypes it is and give the right drug. Either that, or give people cocktails of lots of drugs and hope that you can identify the right one before the other ones kill the patient.

At this point there do not appear to be any magic bullets that will cure cancer, just lots of work and research to chip away at the problem, one subtype or one patient at a time.

And cancer appears to be inherent in what we are, animals. It seems unlikely that we will be able to change what we are sufficiently to avoid cancer. No vaccines are likely.

On the other hand, all the investment in Cancer research is paying off and is chipping away at this family of diseases. There are lots of reasons, not just new drugs, but some new drugs are part of the solution.

Maybe the human race is at a point where we have solved all the easy problems and now have a hard slog to chip away at the rest of them, bit by bit.

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#35
post #30

Earlier quoted context omitted.

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because BP poured nearly two million gallons of Corexit into the Gulf of Mexico, creating unexpected toxins in the fish I ate. If the drug companies were to provide a pill to mitigate my hypothetical cancer, I would take it. As you wrote, cancer risk probably involves effects…

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because... Maybe, or maybe not. When you actually have cause to investigate this stuff deeply, as I have, it's surprising to discover how little is known about these kinds of things. If you could take 100 people of similar age and health and had them all "run eight miles a day…

> Bruce Harold Lipton, is an American developmental biologist best known for promoting the idea that genes and DNA can be manipulated by a person's beliefs. He is a visiting fellow lecturer at the New Zealand College of Chiropractic.

... You've become convinced by this man.

> Surgical oncologist David Gorski has described Lipton as a crank who misunderstands evolutionary biology. He notes that some of Lipton's ideas start out based on research from epigenetics but he twists them into a "woo-sphere".

So could you cite some of the "solid scientific evidence" that you have referred to... because your appeal to authority seems to have failed you... :\

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#36

The same, often perverse, incentives operate on the potential treatment of aging. Lots of work on tinkering with end states, meaning age-related disease in advanced stages, and next to nothing on prevention, meaning periodic repair of the molecular damage that causes aging.

Really? I would think the rich are very much incentivized to fund any research that may slow down their aging (as are the poor, but they don't have enough money). When you have achieved most of the goals in your life, the remaining goal you have is perhaps to elongate that success for however longer you can. For example, several Chinese emperors, starting from the first one, were obsessed with living forever, giving tons of resources and power to "alchemists" who claimed to be able to produce medicine to keep the emperor young.

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#37
post #9

This isn't a great representation of the issue. Everyone loves to hate the drug companies. First of all, the basic science is lacking. The vast majority of animal models in no way resemble the normal process by which humans develop cancer. The models are designed to grow aggressive cancers extremely fast so you can test drugs rapidly, publish your paper and get the next grant. Even more than that, what actually takes…

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because BP poured nearly two million gallons of Corexit into the Gulf of Mexico, creating unexpected toxins in the fish I ate. If the drug companies were to provide a pill to mitigate my hypothetical cancer, I would take it. As you wrote, cancer risk probably involves effects…

You are right. But you could take the cancer pill and then get a heart attack, or dementia, or become suicidally depressed etc. Will we make a pill for all those things as well?

I'm not at all saying we should give up on cancer research (I'm doing a PhD in the field at the moment). My point in the last paragraph is this: prevention is applied to healthy people, but taking pills to prevent a disease is quite an odd notion of 'being healthy'. We should think carefully if the pills4prevention paradigm is going to deliver us the sort of outcomes and lifestyle we really want. I worry that the whole idea encourages an almost absurdly narrow and reductionist view of human health.

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#38
post #30

Earlier quoted context omitted.

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because BP poured nearly two million gallons of Corexit into the Gulf of Mexico, creating unexpected toxins in the fish I ate. If the drug companies were to provide a pill to mitigate my hypothetical cancer, I would take it. As you wrote, cancer risk probably involves effects…

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because... Maybe, or maybe not. When you actually have cause to investigate this stuff deeply, as I have, it's surprising to discover how little is known about these kinds of things. If you could take 100 people of similar age and health and had them all "run eight miles a day…

Wasn't me with the downvote, but just as a friendly comment, you do come off a little "if you knew more, you'd feel as I do" with this comment. Maybe, as another suggests, focus more on information and provide some links?

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#39
post #9

This isn't a great representation of the issue. Everyone loves to hate the drug companies. First of all, the basic science is lacking. The vast majority of animal models in no way resemble the normal process by which humans develop cancer. The models are designed to grow aggressive cancers extremely fast so you can test drugs rapidly, publish your paper and get the next grant. Even more than that, what actually takes…

I was with you up until this, "A holistic approach to improving our health and well being would be preferable, at least incorporating nutrition, exercise and psychology." I'm all for being healthy, getting good sleep,and exercise, but I dont want to go back to blaming cancer on personality types, or a lack of certain vitamins. Those holistic cancer commercials on t.v. are irritating. Once you have cancer, all that ho…

I'm all for conventional treatment - I'm a medical oncologist, administering conventional treatment is my day job. But prevention isn't a treatment for a disease, it's supposed to keep us healthy, which is a fundamentally different goal.

Re: Why Preventing Cancer Is Not the Priority in Drug Development

#40
post #35
post #30

Earlier quoted context omitted.

I could run eight miles a day with full pack, eat only protein and vegetables, have the mental outlook of the Buddha--and yet still get cancer because... Maybe, or maybe not. When you actually have cause to investigate this stuff deeply, as I have, it's surprising to discover how little is known about these kinds of things. If you could take 100 people of similar age and health and had them all "run eight miles a day…

> Bruce Harold Lipton, is an American developmental biologist best known for promoting the idea that genes and DNA can be manipulated by a person's beliefs. He is a visiting fellow lecturer at the New Zealand College of Chiropractic. ... You've become convinced by this man. > Surgical oncologist David Gorski has described Lipton as a crank who misunderstands evolutionary biology. He notes that some of Lipton's ideas…

Hi, first of all, I understand the combative skepticism as I used to be that way myself. I used to scoff at chiropractic and slap my knees at all the hilarious takedowns of woo-merchants by Quackwatch and SBM and it was all great fun.

But a chronic auto-immune illness that became debilitating about 5 years ago, and a long, exasperating, and ultimately futile attempt to find treatment via conventional medicine forced me to consider anything in order to get well, and the method that got me well came via chiropractors and Lipton's ideas.

As of now I'm almost completely recovered, whilst others I know with similar conditions who have stuck with conventional medicine continue to be sick and frustrated.

So, scoff if you will, but had I not learned what I learned from Lipton, I'd have no health and possibly no life.

Now I understand the physiology behind my illness and my recovery, I believe those who say the same kind of approach could be effective for cancer - at least the ones that occur downstream of auto-immune illness (colorectal cancer for example). And I believe the anecdotes of people who've used these techniques to overcome cancer, because it aligns with my own experience. (Though let me be clear: I don't believe chiropractors can "cure cancer", and I don't have much time for chiropractic at all these days, now that I've found better and cheaper alternatives.)

But of course it needs more research so it stops being mere anecdotes and starts becoming hard data. That's the whole point of this thread.

As for "hard science" - all I can point you to are the books by Tanzi and Lipton, and Tanzi's research papers.

Tanzi is Professor of Neurology at Harvard University, and Director of the Genetics and Aging Research Unit at Massachusetts General Hospital. He's been a leading researcher on Alheimer's for over 15 years, and much of his research and writing is focused on the role of emotions in genetic expression and the development of illness.

But he's co-authored books with Deepak Chopra and has been criticized by Jerry Coyne - so he can therefore be disregarded, right?

This is exactly my point.

I profoundly wish there were more hard studies (indeed I put quite a lot of thought into whether I could help facilitate some research based on my own experience).

I understand that Lipton's manner and Tanzi's link to Chopra make them easy to dismiss in the way that you have.

But the dismissals all seem to succumb to the "begging the question" fallacy - dismissing them because "we already know they are wrong" rather than engaging with their arguments and evidence.

I may only be a sample size of one, but significant numbers of people are recovering from illness by following the principles they espouse and significant numbers of qualified medical practitioners accept and endorse their ideas and research findings.

If more attention was paid to this research and if it were then to inspire further research, maybe the world would start making real progress towards overcoming the illnesses that account for most of the ballooning costs of the health systems in western countries.

Update: here's a link to a recent study linking emotion-focused therapies on telemere length in cancer patients. Telemere length is believed to be relevant in cancer risk and recovery potential: http://onlinelibrary.wiley.com/doi/10.1002/cncr.29063/full

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